Provider Demographics
NPI:1386668663
Name:BARGANIER, PAUL VICKERY (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:VICKERY
Last Name:BARGANIER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 LORNA ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216
Mailing Address - Country:US
Mailing Address - Phone:205-822-8161
Mailing Address - Fax:205-822-9439
Practice Address - Street 1:3055 LORNA ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-822-8161
Practice Address - Fax:205-822-9439
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL39191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice